Article Text
Abstract
Objectives The purpose of this study was to determine the prevalence of rheumatoid cachexia and analyze factors that might be associated with it.
Methods This was a cross-sectional study using the data from 83 patients with rheumatoid arthritis (RA). Demographic and socio-economic parameters were collected. The disease activity was assessed by the tender joint count (TJC), swollen joint count (SJC), pain assessed by a visual analogue scale (pVAS), global activity disease evaluated by the physician and the patient using a visual analogue scale (gVAS) and blood markers of inflammation (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)). Anthropometric measurements (weight, height, waist circumference (WC), body mass index (BMI)) were recorded for each patient. WC was interpreted and classified according to recommendations of WHO in 2 categories of risk of metabolic complications: low risk (WC≤93.9 cm in men and WC ≤79.9 cm in women) and high risk (WC≥102.0 cm in men and 88.0 cm for WC≥ woman). The skinfold thickness was measured using the clamp Harpenden in 4 sites: triceps, biceps, subscapular and suprailiac regions. Fat-free mass index (FFMI) and fat mass index (FMI) were calculated using the equation of Durnin and Wormersley and the equation of Siri. Rheumatoid cachexia has been defined by an FFMI <10th percentile and a FMI>90th percentile.
Results 83 patients were included with a mean age of 51.7±13.3 years and a female predominance (87%). The median of RA duration was 7 years [4 to 14]. 9 patients (15.5%) have a rheumatoid cachexia, 8 of them (88.9%) are women with a normal BMI. The rheumatoid cachexia was associated with advanced age and a high metabolic risk (p<0.001). There was no association between rheumatoid cachexia and parameters of disease activity: TJC (p=0.9); SJC (p=0.2); pVAS pain (p=0.5); gVAS (p=0.6); ESR (p=0.5); CRP (p=0.3).
Conclusions This study suggests that rheumatoid cachexia is frequent in patients suffering from RA, which may be associated with advanced age, a normal BMI and the risk of metabolic complications. These results should be verified by studies on a larger scale.
Disclosure of Interest None declared